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South Dakota rates for HCPCS 78494

Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with or without quantitative processing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$56.57 / $56.57 / $56.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.16 / $225.26 / $225.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.56 / $491.02 / $613.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.21 / $328.67 / $513.86
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.16 / $513.86 / $628.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.45 / $371.23 / $406.33
Sanford Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.37 / $93.05 / $106.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.05 / $303.43 / $465.96
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.00 / $421.20 / $421.20